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Hypertrophic Cardiomyopathy Patients With Paroxysmal Atrial Fibrillation Have a High Burden of Left Atrial Fibrosis by Cardiac Magnetic Resonance Imaging

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dc.contributor.author Sivalokanathan, S.
dc.contributor.author Zghaib, T.
dc.contributor.author Greenland, G.V.
dc.contributor.author Vasquez, N.
dc.contributor.author Kudchadkar, S.M.
dc.contributor.author Kontari, E.
dc.contributor.author Lu, D.-Y.
dc.contributor.author Dolores-Cerna, K.
dc.contributor.author van der Geest, R.J.
dc.contributor.author Kamel, I.R.
dc.contributor.author Olgin, J.E.
dc.contributor.author Abraham, T.P.
dc.contributor.author Nazarian, S.
dc.contributor.author Zimmerman, S.L.
dc.contributor.author Abraham, M.R.
dc.date.accessioned 2019-07-04T17:00:16Z
dc.date.available 2019-07-04T17:00:16Z
dc.date.issued 2019
dc.identifier.uri https://hdl.handle.net/20.500.12866/6824
dc.description.abstract Objectives: This study hypothesized that paroxysmal atrial fibrillation (PAF) reflects the presence of a more severe cardiac hypertrophic cardiomyopathy (HCM) phenotype. Background: HCM is characterized by myocyte hypertrophy, fibrosis, and a high prevalence of PAF. It is currently unresolved whether atrial fibrillation (AF) is a marker or a mediator of adverse outcomes in HCM. Methods: This study retrospectively examined 45 HCM patients who underwent cardiovascular magnetic resonance (CMR) imaging in sinus rhythm. The function of all 4 cardiac chambers was assessed, as well as late gadolinium enhancement (LGE) in the left atrium (LA) and left ventricle (LV), as indicators of fibrosis. A fat-saturated, 3-dimensional inversion recovery–prepared, fast-spoiled, gradient-recalled echo sequence, and the image intensity ratio method were used to measure LA-LGE; LGE in the LV was quantified using a semi-automated threshold technique. Results: HCM patients (n = 45) were divided into 2 groups (PAF, no AF) based on history of PAF. All HCM patients had LGE in the LA posterior wall. The PAF group (n = 18) had higher LA volume, a lower LA ejection fraction, a lower global peak longitudinal LA strain (PLAS), and a higher amount of LA-LGE compared with the no AF group (n = 27). A modest inverse association was noted between the LA ejection fraction, PLAS, and LA-LGE; a positive association was present between LV-LGE and LA-LGE. The PAF group had lower ejection fractions in the LV, right atrium, and right ventricle compared with those in the no AF group. Conclusions: PAF is associated with a greater degree of structural LA remodeling and global myopathy, which suggests a more severe cardiac HCM phenotype. en_US
dc.language.iso eng
dc.publisher Elsevier
dc.relation.ispartof urn:issn:2405-500X
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject human en_US
dc.subject adult en_US
dc.subject female en_US
dc.subject male en_US
dc.subject middle aged en_US
dc.subject Article en_US
dc.subject priority journal en_US
dc.subject adverse outcome en_US
dc.subject disease burden en_US
dc.subject controlled study en_US
dc.subject prevalence en_US
dc.subject phenotype en_US
dc.subject retrospective study en_US
dc.subject beta adrenergic receptor blocking agent en_US
dc.subject clinical article en_US
dc.subject gadolinium en_US
dc.subject three dimensional imaging en_US
dc.subject antiarrhythmic agent en_US
dc.subject cardiovascular magnetic resonance en_US
dc.subject cardiovascular magnetic resonance imaging en_US
dc.subject cardiovascular parameters en_US
dc.subject heart ejection fraction en_US
dc.subject heart left atrium en_US
dc.subject heart left ventricle en_US
dc.subject heart right atrium en_US
dc.subject heart right ventricle en_US
dc.subject Holter monitoring en_US
dc.subject hypertrophic cardiomyopathy en_US
dc.subject late gadolinium enhancement in the left atrium en_US
dc.subject paroxysmal atrial fibrillation en_US
dc.subject radiological parameters en_US
dc.subject sinus rhythm en_US
dc.title Hypertrophic Cardiomyopathy Patients With Paroxysmal Atrial Fibrillation Have a High Burden of Left Atrial Fibrosis by Cardiac Magnetic Resonance Imaging en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1016/j.jacep.2018.10.016
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.00 es_PE
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.01.08


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